• Title/Summary/Keyword: 심장크기

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The Mid-term Results of Pulmonary Vein Isolation for Atrial Fibrillation associated with Mitral Valvular Heart Disease (승모판 질환에 동반된 심방세동에 대한 폐정맥 분리술의 중기성적)

  • Kim, Kyung-Hwan;Kim, Tae-Hun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.345-350
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    • 2001
  • 배경: 항부정맥 술식으로서의 메이스 술식은 우수한 동율동 전환율을 보고 있으나, 술식의 복잡성과 상대적으로 긴 수술 시간 등으로 모든 환자들에게 적용할 수는 없기에, 일부 환자군에서 보다 간단한 항부정맥술인 폐정맥 분리술을 시행 받은 환자들을 대상으로 동율동 전환율 등의 수술 성적과 위험 인자 등에 대해 알아보고자한다. 대상 및 방법: 1995년 10월부터 1999년 2월까지, 폐정맥 분리술을 시행받은 96명의 환자들을 대상으로 후향적 연구를 시행하였다. 남자가 37명(38.5%), 여자가 59명(61.5%) 이었고, 평균 연령은 46.9$\pm$11.6세 이었다. 승모판 협착 환자가 50명(52.1%), 폐쇄 부전이 24명(25%), 협착과 폐쇄부전이 같이 있었던 경우가 22명(22.9%)이었다. 판막 술식과 폐정맥 분리술을 시행하고 좌심방이 제거술을 시행하였다. 모든 환자들은 술 후 6개월 내지 1년 이내에 외래에서 심전도와 심초음파를 시행받았다. 평균 추적 관찰 기간은 25.9$\pm$11.5개월 이었다. 술 후 최근 추적일까지 동율동으로 전환된 군과 안된 군으로 나누어 분석을 하였다. 결과: 조기 성적으로는 사망이 3명(3.1%), 술 후 6개월 이내의 추적관찰 유실이 2명(2.1%) 이었다. 조기 합병증으로 재수술이 필요 했던 출혈이 4례, 심폐바이패스 이탈 실패오 심실보조장치 등의 삽입이필요했던 경우가 1례, 뇌혈관질환 1례, 심근경색이 1례 등이 있었다. 만기 합병증으로는 동기능 부전 증후군으로 영구 심박동기를 삽입한 경우가 1례, 일시적인 뇌경색 1례 있었고 다른 판막과 연관된 합병증은 없었다. 동율동 전환 환자 수는 75명(82%)이었다. 동율동으로의 전환이 어려운 위험인자로 50세로 이상의 연령(p=0.03), 65mm 이상의 좌심방 크기(p=0.03), 동반 우심 술식 시행(p=0.02)등이 있었다 결론: 승모판 질환을 동반한 심방 세동 환자에서 폐정맥 분리술을 시행하여 만족할 만한 동율동 전환율을 얻을 수 있었다.

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The Correlation between Radiologic Findings and Clinicopathological Prognostic Factors in Small Peripheral Adenocarcinoma of Lung (말초 폐 발생 소형 선암에서 화상적 소견과 병리적, 임상적 예후와의 관계)

  • Park, Jae-Kil;Cho, Kyu-Do;Park, Kuhn;Moon, Seok-Whan;Rha, Suk-Joo;Choi, Si-Young;Jung, Jung-Im
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.423-431
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    • 2004
  • Background : Tumor size in lung cancer is not as good a prognostic factor for adenocarcinoma as it is for other types of lung cancer; therefore it is difficult to estimate the prognosis preoperative. However, there have recently been some reports on the radiologic findings correlating to the clinicopathologic prognostic factors in peripheral small adenocarcinoma of lung. We tried to evaluate the prognostic importance of High-Resolution CT (HRCT) findings of such adenoearcinoma, Material and Method: One houndred and seventy-six surgically resected small peripheral adenocarcinoma measuring 3 cm or less in greatest dimension were reviewed radiologically and clinicopathologically. Result: The patients with greater extent of ground-glass attenuation (GGA) had better clinico-pathological factors. The tumors with gross appearance of GGA or bubble-like shape showed better clinicopathological prognostic factors than scar-like or solid shape. Conclusion: HRCT findings of small peripheral adenocarcinomas of the lung correlated well with the histologic and clinical prognostic factors. We can predict the post-operative prognosis with the radiologic findings.

Optimal Management of Patent Ductus Arterisus in Premature (미숙아 동맥관개존증의 효과적 치료)

  • 전태국;박표원
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.585-590
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    • 1997
  • Between December 1994 and October 1996, 57 premature infants with evidence of a hemodynamically significant PDA associated with cardiopulmonary compromise underwent indomethcin therapy(Group I, n=48) or surgical ligation(Group II, n=9) because of indomethacin failure. The gestational alee(29.6$\pm$ 3.1weeks vs. 28.1 $\pm$ 1.6weeks) and birth weight(1,413 $\pm$ 580gm, ,098 $\pm$ 235gm) showed no significant differences between the two groups. Medical management included fluid restriction, diuretics, and indomethacin therapy(one or two cycles). Surgical libation was done at the neonatal intensive care unit(NICU) without moving the patient to the operation room. There was no complication associated with the operation. There were 9 deaths in Group I(19%, 9/48) and 2 deaths in Group II(22% , 219). The main causes of deaths were persistent bronchopulmonary dysplasia with sepsis(n=8) and intrapulmonary hemorrhage(n=3). The rate of medical treatment failure including death and complication in premature infants whose body weights were less than 1500gm was higher(41%, 15/38) than in premature infants whose body weights were more than 1500gm(16%, 3/19). Early surgical ligation of PDA may be applicable in the premature infant with a large size, low birth weight(<1500 gm), or associated intracardiac anomalies. Perfoming the operation in the NICU may be safe in s ead of moving the patient to the operating room.

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The Norwood-Rastelli Procedure for Left Ventricular Outflow Tarct Obstruction with a Ventricular Septal Defect - Three case report - (심실중격결손이 동반된 좌심실유출로협착 환아에서의 Norwood-Rastelli Procedure -3예 보고 -)

  • Kim, Dong-Jung;Kwak, Jae-Gun;Oh, Se-Jin;Jang, Woo-Sung;Kim, Dong-Jin;Lee, Chang-Ha;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.624-628
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    • 2007
  • Between 2001 and 2006, 3 neonates that had multilevel left ventricular outflow tract obstruction and a ventricular septal defect underwent the Norwood-Rastelli procedure. The body weights ranged from 2.9 to 3.1 kg. The patients had a near normal sized mitral valve and left ventricle. We simultaneously performed a modified Norwood procedure with native tissues-to-tissue anastomosis without circulatory arrest, and a Rastelli type procedure using a non-valved conduit from the right ventricle to the pulmonary artery and intracardiac patch baffling from the left ventricle to the pulmonary valve via the ventricular septal defect. The postoperative courses were uneventful. During follow-up, there was one late mortality caused by a cardiac catheterization related complication at 7 months after surgery, One patient required a Rastelli conduit change. Two patients are doing well during a follow-up period of 1 and 5 years, respectively.

Development of a Method for Measuring Image Quality of Intra Vascular Ultrasound Images using Image Analysis Program (영상 분석 프로그램을 이용한 혈관 내 초음파 영상의 화질 측정 방법 고안)

  • Seo, Young-Hyun;Han, Jae-Bok;Song, Jong-Nam
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.621-628
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    • 2021
  • Prior studies on frequency-related image quality analysis of intravascular ultrasound catheters are lacking both in Korea and abroad. Therefore, this study was conducted to prepare a standard for measuring the image quality using the program and to suggest a measuring method to researchers related to the quality analysis of intravascular ultrasound images. For the target, the vessel lumen size is 3.0 - 4.0 mm. Before using intravascular ultrasound, thoroughly clean the ultrasound catheter so that no air or foreign substances enter it. Normal vascular images and lesion vascular images of sufficiently dilated images were used. As a standard image acquisition method, the image of the end-systolic section, which has the best evaluation of vascular lesions when using intravascular ultrasound, was acquired retrospectively through the DCAS PACS program to set the standard. When setting the measurement method criteria, we proposed a standard setting method that corresponds to the concentric and eccentric circles of normal and lesion vessels. By applying this criterion, we proposed a method for measuring the lumen and lateral cavities of normal and lesion vessels of interest and background area. In conclusion, if the image quality of intravascular ultrasonography is measured through the method devised by these researchers, consistent quality measurement is possible regardless of the type of intravascular ultrasound catheter. Therefore, it is thought that it can be applied as a guideline for the actual image quality measurement method in the study related to intravascular ultrasound image quality.

Microplastics in the Marine Environment and Their Impacts on Human Health (해양 환경의 미세 플라스틱과 인간의 건강에 미치는 영향)

  • Bak, Jia;Kang, Hyun Bon;Choi, Yun-Sik
    • Journal of Life Science
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    • v.31 no.4
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    • pp.442-451
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    • 2021
  • Microplastics are fragments of any type of plastic with a size less than 5 mm. Ocean pollution by microplastics is now a worldwide concern in relation to marine ecosystems and human health. The widespread contamination by microplastics means that they can be ingested by and accumulated in diverse species of wildlife, such as fish, mussels, oysters, clams, and scallops. Once ingested, the microplastics can be observed in the intestines, liver, and kidney, and even in the brain. Seafood is one of the major sources of protein intake in humans; therefore, seafood consumption could be pathway for human microplastics exposure. Accumulating evidence indicates that repeated oral exposure to microplastics induces pathologic and functional changes in the reproductive, cardiac, gastrointestinal, endocrine, and even nervous systems of rodents. Maternal exposure to microplastics during gestation and lactation alters metabolic homeostasis in the offspring. Given that seafood provides more than 20% of the total protein intake by over 310 million people worldwide, a reasonable assumption is that microplastics could be substantially accumulated in the human body and impair physiological function. In this review, we have summarized the current status of microplastics contamination in the ocean, their accumulation and toxicities in marine animals and rodents, their exposure to humans, and their potential impacts on human health.

Effect of L-carnitine on Field Potential and ATP-dependent K+ Channel of Rat Cardiac Muscles (L-carnitine 투여가 흰쥐의 심근 Field Potential과 ATP-dependent K+ channel에 미치는 영향)

  • Kim, Jee-Youn;Sim, Young-Je;Chang, Hyun-Kyung;Kim, Chang-Ju
    • Korean Journal of Exercise Nutrition
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    • v.13 no.1
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    • pp.15-21
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    • 2009
  • Ergogenic aids are substances, devices, and practices that enhance an individual's energy use and production, and recovery from fatigue. L-carnitine increases enhance performance and aerobic capacity by stimulating lipid oxidation in muscle cells during long term exercise. L-carnitine is a well known and widely used ergogenic aid. In the present study, the effect of L-carnitine at concentrations of 100 nM, 1 μM, 10 μM, and 100 μM on the amplitude of field potential in rat cardiac muscle slices was measured using multi-channel extracellular recording (MED 64) system. In the present result, L-carnitine was shown to enhance field potential as a does-dependent manner. The increasing effect of the L-carnitine on field potential was not affected by application of the glibenclamide, an ATP-dependant K+ channel antagonist. The increasing effect of L-carnitine on field potential was suppressed by application of the diazoxide, an ATP-dependent K+ channel agonist. Present data show that L-carnitine potentiates field potentials by inhibition on ATP-dependant K+ channel in cardiac muscles. The enhancing effect of the L-carnitine on the field potential in cardiac muscles can be suggested as one of the underlying mechanism of ergogenic aid of the L-carnitine.

Clinical Characteristics of Pleomorphic Carcinoma (다형성 암종의 임상적 고찰)

  • Lee, Deok-Heon;Park, Hoon;Park, Chang-Kwon;Kwon, Kun-Young;Park, Nam-Hee;Choi, Sae-Young;Lee, Kwang-Sook;Yoo, Young-Sun
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.397-403
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    • 2003
  • Background: The research sought to identify the clinical features of pleomorphic carcinoma of the lung generally known as a rare subtype in accordance with the lung cancer classification done in 1999 by WHO. Material and Method: 250 cases of surgically resected lung cancers were collected in this hospital from January 1992 to December 2001. This study included 42 cases of pleomorphic carcinoma diagnosed through light microscope and immunohistochemistry. Result: Out of 42 cases, males represented 31, and females 11, the age ranged from 26 to 77. Main clinical symptoms included coughing, hemoptysis, sputum. Diagnoses disclosed the stage as stage la in 3 cases (7%), Ib in 16 (38%), IIa in 1 (2%), IIb in 8 (19%), IIIa in 15 (35%), and IIIb in 1 (2%). Out of these, no lymph node metastasis was represented in 23 cases (54%), while N1 and N2 involving lymph node metastasis was shown 19 cases (46%). A total of 19 patients developed metastasis, comprising the brain in 5 cases (26%), bone in 4 (21%), muscle in 4 (21%), Lymph node in 2 (10%), and 1 liver, ovary, contralateral lung, and adrenal gland, respectively. The size of the tumor ranged from 1 cm to 11 cm, averaging 5.85 cm. Out of the 42 patients, the total two-year and five-year survival rates in accordance with the Kaplan-Meier method represented 26% and 13%, respectively, These figures compared to the corresponding 44% and 34% in cases other than pleomorphic carcinoma from the survey target of 256 cases, proved to be significantly low (p<0.002). No significant difference was found in the survival rates compared between age and tumor size, between stage I and above stage II, and between N0 and above N1. Patients who developed postoperative metastasis all died, and showed significantly low survival rates (p<0.002) compared to those patients without metastasis. Conclusion: With the new diagnosis method of f999 WHO's lung cancer classification applied, pleomorphic carcinoma showed a higher prevalence rate than under previous classifications, their postoperative survival rate was significantly low compared to histologic type of non small cell lung carcinomas.

Lung Biopsy after Localization of Pulmonary Nodules with Hook Wire (Hook Wire를 이용한 폐결절의 위치선정 및 생검)

  • Kim, Jin-Sik;Hwang, Jae-Joon;Lee, Song-Am;Lee, Woo-Surng;Kim, Yo-Han;Kim, Jun-Seok;Chee, Hyun-Keun;Yi, Jeong-Geun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.681-686
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    • 2010
  • Background: A chest computed-tomography has become more prevalent so that it is more common to detect small sized pulmonary nodules that have not been found in previous simple chest x-ray. If those detected nodules are undersized or located in pulmonary parenchyma, it is difficult to accomplish a biopsy since it is vulnerable to explore them either grossly or digitally. Thus, in our hospital, a thoracoscopic pulmonary wedge resection was performed after locating a lesion by means of hook wire with CT-guided. Material and Method: 31 patients (17 males and 14 female patients) from December in 2006 to June in 2010 became our subjects; their 34 pulmonary nodules were subjected to the thoracoscopic pulmonary wedge resection after locating a lesion by means of hook wire with CT-guided. Also we analyzed a possibility of hook wire dislocation, a frequency of conversion to open thoracotomy, time consumed to operation after location of a lesion, operation time, post operation complication, and histological diagnosis of the lesion. Result: 12 of 34 cases were ground glass lesion, whereas 22 cases of them were solitary pulmonary lesion. The median value of the lesion was 8mm in size (range: 3 to 23 mm), while the median value was 12.5 mm in depth (range: 1 to 34 mm). The median value of time consumed from location of the lesion to anesthetic induction was 86.5 minutes (41~473 minutes); furthermore the mean value of operation time was 103 minutes (25~345 minutes). Intrathoracic wire dislocation was found in one case, but a target lesion was successfully excised. Open thoracotomy was performed in four cases due to pleural adhesion. However, there was no case of conversion to open thoracotomy due to failure to detect a target lesion. In histological diagnosis, metastatic cancer were found in 15 cases, which were the most common, primary lung cancer were in 9 cases, non-specific inflammation were in 3 cases, tuberculosis inflammation were in 2 cases, lymph nodes were in 2 cases, active tuberculosis were in 1 case, atypical adenomatous hyperplasia was in 1 case and normal lung parenchymal finding was in 1 case, respectively. Conclusion: In our hospital, in order to accomplish a precise histological diagnosis of ground-glass lesion and pulmonary nodules in lung parenchyma, location of pulmonary nodules were exactly located with hook wire under chest computed-tomography, which was followed by lung biopsy. We concluded that this was an accurate, minimally invasive and valuable method to minimize the complications and increase of cost of medical service provided.

Impact of Hemodialysis on Left Ventricular Performance: A Doppler Echocardiographic Study (혈액투석 유지요법 환자에서 투석 전후의 좌심실 Doppler 심초음파를 이용한 기능지표의 변화)

  • Kang, Dong-Oh;Lee, Du-Ha;Kim, Hyun-Seo;Kim, Hyun-Su;Kim, Sung-Rok;Park, Jong-Seon
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.309-317
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    • 1999
  • Background: Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function. we performed M-mode and Doppler echocardiographic studies before and after hemodialysis. Methods: The study population consisted of 30 patients(15 patients were male, mean age $45{\pm}10$ years) with CRF on maintenance hemodialysis. They have normal left ventricular systolic function(Fractional shortening>30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction (EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxation time(IVRT), deceleration time(DT). and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance (IMP) was calculated from each of the Doppler velocity indices. Results: The weight reduction after hemodialysis was $2.1{\pm}1.0kg$(p<0.0001), After hemodialysis, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant reduction in peak E velocity, E/A ratio(p<0.0001. p<0.001), and significant increase in IVRT and IMP(p<0.05, p<0.0001) were noted. Conclusion: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And an increased IMP suggests that diastolic function may be aggravated after hemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.

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